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POLICYHOLDER COPY NA P.O. BOX 8192, PLEASANTON, CA 94588 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE: 10-19-2020 CALIFORNIA DEPARTMENT OF MOTOR VEHICLES MOTOR CARRIER PERMIT BRANCH PO BOX 932370 SACRAMENTO CA 94232-3700 GROUP: POLICY NUMBER: 9282808-2020 CERTIFICATE ID: 1 CERTIFICATE EXPIRES: 09-01-2021 09-01-2020/09-01-2021 NA CA#: 0364410 INCEPTION DATE:09-01-2020 Di This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 30 days advance written notice to the employer. We wil! also give you 30 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. Authorized Representative President and CEO EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 10-13-2020 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. ENDORSEMENT #1651 - ANDREW PETER HERNANDEZ P - EXCLUDED. ENDORSEMENT #1651 - ZACHARY HERNANDEZ OTR - EXCLUDED. ENDORSEMENT #1651 - SIERRA RENEE HERNANDEZ SJ - EXCLUDED. EMPLOYER WEST COAST EXPLORATION, INC. (A CORP) PO BOX 133 ESCALON CA 95320 NA [P14,H0j (REV.7-2014) PRINTED : 10-19-2020